背景:髌骨下极骨折是常见的关节外骨折,治疗时存在一定困难,经髌骨胫骨结节环形钛缆固定为髌骨下极骨折治疗提供了新的思路.目的:分析经髌骨胫骨结节环形钛缆固定治疗髌骨下极骨折的效果.方法:回顾性分析2014年2月至2016年2月经髌骨胫骨结节环形钛缆固定治疗45例髌骨下极骨折患者的临床资料,根据患者术后随访情况评价治疗效果.结果:45例患者骨折部位左侧23例,右侧22例;受伤至治疗时间3~11 h,平均(5.2±1.5)h.手术时间82~146 min,平均(112.6±22.6)min,术中出血量80~350 ml,平均(202.6±70.7)ml,术后无明显并发症.45例全部获得随访,随访时间为16~36个月,平均(20.6±4.8)个月,术后6周随访时骨折均达到临床愈合.Insall-Salvati指数为0.9~1.2,平均1.1±0.1;Bostman评分为24~30分,平均(27.3±2.0)分.结论:经髌骨胫骨结节环形钛缆固定治疗髌骨下极骨折效果满意,不影响患膝关节术后功能,可作为一种临床治疗方案.%Background:The patellar inferior fracture is a common extra-articular fracture.There are some difficulties in the treatment of the patellar inferior pole fracture.It is a new idea to treat the patellar inferior fracture by the patellar tibial tuber-osity titanium cable cerclage.Objective:To analyze the effect of titanium cable cerclage through patellar tibial tubercle in the treatment of patellar inferior pole fracture.Methods:The clinical data of 45 patients with inferior patellar fractures ad-mitted to our hospital from February 2014 to February 2016 were retrospectively analyzed.The therapeutic effect was evalu-ated according to the follow-up of the patients.Results:There were 23 cases on the left side and 22 cases on the right side. The duration of injury ranged from 3 h to 11 h with the mean as(5.2±1.5)h.The average surgery time of all patients was (112.6±22.6) min (82-146 min), and the mean intraoperative blood loss was (202.6±70.7) ml (80-350 ml).There was no complication observed after operation. All patients were followed up for 16-36 months with the mean as (20.6 ± 4.8) months.At 6 weeks after operation, all fractures were clinically cured.The Insall-Salvati index ranged from 0.89 to 1.17 with the mean as 1.1±0.1 and the Bostman score ranged from 24 to 30 with the mean as 27.3±2.0.Conclusions:The out-come of patellar tibial tuberosity titanium cable cerclage in the treatment of patellar inferior pole fracture is satisfactory without any impact on the function of the knee joint,thus it can be used as a clinical treatment choice.
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